NCLEX-RN
NCLEX RN Exam Questions
1. Following a diagnosis of acute glomerulonephritis (AGN) in their 6-year-old child, the parent's remark: "We just don't know how he caught the disease!"? The nurse's response is based on an understanding that:
- A. AGN is a streptococcal infection that involves the kidney tubules.
- B. The disease is easily transmissible in schools and camps.
- C. The illness is usually associated with chronic respiratory infections.
- D. It is not "caught"? but is a response to a previous B-hemolytic strep infection.
Correct answer: D
Rationale: The correct answer is that acute glomerulonephritis (AGN) is not 'caught' but is a response to a previous B-hemolytic strep infection. AGN is generally accepted as an immune-complex disease triggered by an antecedent streptococcal infection occurring 4 to 6 weeks prior. It is considered a noninfectious renal disease. Choice A is incorrect because AGN is not a streptococcal infection that involves the kidney tubules but rather a noninfectious renal disease. Choice B is incorrect as AGN is not easily transmissible in schools and camps but is a result of a previous streptococcal infection. Choice C is incorrect as AGN is not usually associated with chronic respiratory infections, but with a previous streptococcal infection.
2. Which of the following diseases is caused by the Bordetella pertussis bacterium?
- A. German Measles
- B. RSV
- C. Meningitis
- D. Whooping Cough
Correct answer: D
Rationale: Bordetella pertussis is the bacterium responsible for causing Whooping Cough, also known as pertussis. Meningitis can be caused by various bacteria, but not specifically by Bordetella pertussis. German Measles, also known as Rubella, and RSV (Respiratory Syncytial Virus) are viral infections and are not caused by the Bordetella pertussis bacterium. Therefore, the correct answer is Whooping Cough, caused by Bordetella pertussis.
3. When assessing a patient being treated for Parkinson's Disease with classic symptoms, the nurse expects to note which assessment finding?
- A. Tremors
- B. Low Urine Output
- C. Exaggerated arm movements
- D. Risk for Falls
Correct answer: A
Rationale: When assessing a patient with Parkinson's Disease, the nurse should expect to note tremors as one of the cardinal signs of the condition. The classic symptoms of Parkinson's Disease include tremors, rigidity, bradykinesia (slow movements), and postural instability. Therefore, choices B, C, and D are incorrect. Low urine output is not a typical assessment finding associated with Parkinson's Disease. Exaggerated arm movements are not characteristic of the usual motor symptoms seen in Parkinson's Disease. While patients with Parkinson's Disease are at an increased risk for falls due to balance and coordination issues, 'Risk for Falls' is not an assessment finding but rather a potential nursing diagnosis based on the assessment findings.
4. The healthcare provider is caring for a 20 lbs (9 kg) 6-month-old with a 3-day history of diarrhea, occasional vomiting, and fever. Peripheral intravenous therapy has been initiated, with 5% dextrose in 0.33% normal saline with 20 mEq of potassium per liter infusing at 35 ml/hr. Which finding should be reported to the healthcare provider immediately?
- A. 3 episodes of vomiting in 1 hour
- B. Periodic crying and irritability
- C. Vigorous sucking on a pacifier
- D. No measurable voiding in 4 hours
Correct answer: D
Rationale: The correct answer is 'No measurable voiding in 4 hours.' This finding should be reported to the healthcare provider immediately. The concern is the possibility of hyperkalemia, which could occur with continued potassium administration and a decrease in urinary output since potassium is excreted via the kidneys. It is crucial to monitor urinary output in pediatric patients receiving potassium-containing IV solutions to prevent electrolyte imbalances and potential complications. Choices A, B, and C are not the most critical findings that require immediate reporting. '3 episodes of vomiting in 1 hour' may suggest a need for antiemetic therapy or further assessment of the underlying cause but does not pose an immediate risk like the potential electrolyte imbalance from decreased urinary output. 'Periodic crying and irritability' and 'Vigorous sucking on a pacifier' are common behaviors in infants and are not indicative of a critical condition that requires urgent attention in this scenario.
5. A patient diagnosed with epilepsy is receiving discharge education from a nurse. Which of the following teachings should be emphasized the most?
- A. Avoid consuming alcohol and drugs
- B. Adhere to follow-up appointments with the neurologist, physician, or other healthcare provider as directed
- C. Continue taking anticonvulsants, even if seizures have ceased
- D. Wear a medical alert bracelet or carry an ID card indicating epilepsy
Correct answer: C
Rationale: The most critical teaching that the nurse should stress to a patient with epilepsy is to continue taking anticonvulsants even if seizures have stopped. Suddenly stopping antiepileptic drugs can lead to seizures and an increased risk of status epilepticus, a life-threatening condition. Choice A, advising to avoid alcohol and drugs, is important but not as crucial as maintaining anticonvulsant therapy. Choice B, emphasizing follow-up appointments, is essential but ensuring medication compliance is more critical to prevent seizure recurrence. Choice D, wearing a medical alert bracelet, is important for emergency identification but does not directly impact the patient's immediate safety like medication adherence does.
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